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Alam Kiron/MCHIP

Community Health and Civil Society Engagement

Effective community-based approaches are critical to improving reproductive, maternal, newborn, child and adolescent health. They require strengthening the capacity of health systems to engage communities, and building strong systems of service delivery and social and behavior change outside of health facilities to reach those not currently accessing key health services.

MCSP promoted the institutionalization of community health as a central component of country health systems. We worked to link community health and health systems strengthening efforts, taking an expanded view of what a health system is—including not only health services, but all actors involved in protecting and building health (health promotion). The Program took into account the centrality of household and community production of health, underlying the health promotion agenda, as well as evidence for effective community-based strategies to prevent child and maternal deaths.

In the full continuum of RMNCH care and services, MCSP supported health promotion, prevention and curative service delivery in communities and with communities, and participation through various groups. We also contributed to global learning on effective and sustainable practices in community health, giving close attention to the fit between program strategies and country realities.

MCSP developed a conceptual model — called Viable, Integrated Community Health Platforms — to strengthen national institutionalization of community health. The component “lenses” of this model are intended to illuminate essential elements that community health strategies need to systematically address to advance comprehensiveness of services, sustainability and high-quality care.

These elements include:

  • Optimizing integrated packages of RMNCH interventions at the community level;
  • Strengthening the community health worker workforce and its support through community infrastructure, including effective community engagement and participation;
  • Supporting more effective government, civil society, and private partnerships to institutionalize and coordinate community health and to build capacity and shared ownership; and
  • Placing emphasis on use of local information for equity, learning and adaptation.

Through the CORE Group, MCSP tapped into tools and a network of more than 70 organizations that foster learning, idea sharing, and capacity building. This work was facilitated through holding global and U.S.-based conferences, conducting national and regional meetings, and linking to the Community Health Network and Technical Working Groups.

Key Results

  • MCSP played a central strategic leadership role in the coordination, planning and execution of the Institutionalizing Community Health Conference, with conference co-hosts USAID and UNICEF, and in collaboration with the World Health Organization (WHO) and the Bill & Melinda Gates Foundation. Key products from the conference include 10 critical principles and an advocacy slide deck, both of which were developed with substantial technical input from MCSP. (All resources are available here.)
  • MCSP collaborated with the WHO on Implementation Principles for Social, Behavioral, and Community Engagement Interventions. The background paper and principles are included as Annex 6 of An evidence map of social, behavioural and community engagement interventions for reproductive, maternal, newborn and child health, released by WHO in November 2017.
  • The Social Accountability Resources and Tools guide was part of broader MCSP efforts to promote civil society engagement in national health programs.
  • The Program worked in Bangladesh, Ethiopia, Guinea, Haiti, Mozambique and Rwanda on community mobilization and capacity-strengthening activities through various approaches — including the use of community action cycle (CAC) — and built on existing civil society organization and community structures in order to increase demand and access to high-quality reproductive, maternal, newborn and child health services. The CAC is a proven community mobilization approach that fosters individual and collective action to address key health program goals and related outcomes.
  • At the national level, MCSP developed policies and strategies on community health, such as: infant and young child feeding and baby-friendly community/hospital initiatives; permissive policies to allow community health workers to diagnose and treatment pneumonia and malaria; and the community mobilization framework. The Program also developed community engagement and mobilization strategies and integrated them into national community health policy in Guinea, and supported the same process in Rwanda, Haiti and DR Congo.
Maternal and Child Survival Program